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Individual

DR. ASHLEY G BENNETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
4650 W SUNSET BLVD, MS 76, LOS ANGELES, CA 90027-6062
(323) 669-2113
(323) 361-8003
Mailing address
4650 W SUNSET BLVD, MS 76, LOS ANGELES, CA 90027-6062
(323) 669-2113
(323) 361-8003

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
27220
OK
208000000X
Pediatrics Physician
Primary
A121634
CA
208000000X
Pediatrics Physician
MD11684
HI
208000000X
Pediatrics Physician
ME113308
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003125369A
GA
05
005830200
FL
01
14KY4
BLUECROSS BLUE SHIELD OF FLORIDA
FL
Enumeration date
06/25/2009
Last updated
03/02/2015
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